Essential Tremor

Overview

What is essential tremor?

Essential tremor, sometimes called benign (non-cancerous) or familial tremor, is an uncontrollable shaking, most often in the hands and forearms. You might notice this tremor when your arms are reaching out in front of your body. It is caused by problems in communication between certain areas of the brain. Tremor affects people in different ways. Some people hardly notice it. Other people may be embarrassed by it.

Causes & Risk Factors

What causes essential tremor?

It is not clear why some people get essential tremor. It seems to run in families. You may be more likely to have essential tremor if a parent or other close family member has tremor. Tremor can start at any age, but it often begins after age 40. It can get worse as you get older.

Are there different kinds of tremor?

Yes. Many things can cause tremor, and not all tremors are essential tremors. For example, Parkinson's disease causes tremor that you might notice when your hands are resting in your lap or at the sides of your body. A stroke can cause tremor that gets worse when you reach for something. Thyroid problems or low blood sugar can cause mild tremor. Tremor can be caused by some medicines, including heart medicines, decongestants, medicines for breathing problems and tricyclic antidepressants. Drinks that contain caffeine also may cause tremor.

Diagnosis & Tests

How can my doctor tell if I have essential tremor?

Tell your doctor if you notice that your head or your hands shake, or if your voice quivers. You may find yourself having trouble eating with a spoon or fork, drinking from a cup, threading a needle or writing. The tremor may get worse with emotional or physical stress, tiredness or heat. Your doctor will do an exam to look for possible causes. If he or she doesn't find another cause of your tremor, you may be diagnosed with essential tremor.

Treatment

How is essential tremor treated?

Your doctor will ask you to avoid caffeine, cold medicines and certain other medicines if they seem to make your tremor worse. Your doctor may prescribe a medicine such as a beta blocker or primidone. These medicines won't make your tremor go away. However, the medicine may control the tremor enough to allow you to do normal activities without frustration or embarrassment. Surgery is an option for some people whose tremors are very disabling and who do not have good results with medication.